Brian Alexander Nordstrom, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

125074696 Issued in IL

Practice address

1901 W Harrison St
Chicago, IL 60612-3714

Phone

(312) 864-6000

NPI assigned

Jun 13, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Anesthesiology

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Tahoe Anesthesia Medical GroupGroup PAC ID 5698748663, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Tahoe Anesthesia Medical Group

  • Pain Medicine (Anesthesiology) Physician
  • South Lake Tahoe, CA
  • NPI 1962513770

  NV

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barton Healthcare System

  • General Acute Care Hospital
  • South Lake Tahoe, CA
  • NPI 1003867565
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1770143687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDSTROM",
        "first_name": "BRIAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125074696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Nordli, MD
• Douglas Nordli
• Kiersten Nordli, FNP
• Gregory Brian Nordlund, M.A., ATC/L, PES
• Nordstrom Inc & Subsidiaries
• Hannah Nordstrom
• Sherry Kaye Nordstrom, MD
• Joseph Noreik, MA
• Kristina Noren, LCSW
• Irsenia Colleen Norfleet, D.D.S.

• Anesthesiology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.